Workers' Compensation

Mastering Workers' Compensation Claims Management: A Guide for Temp Staffing Agencies in the Southeast

By December 20, 2023 No Comments

According to one recent study, the average cost of a workers' compensation claim related to motor vehicle crashes alone hit an enormous $89,152 per worker in 2023.

If you needed a single statistic to help underline the importance of what this type of coverage can do for people, let it be that one.

Proper management of the workers' compensation claims process begins with the proper training of supervisory staff.

This helps to provide not only essential instructions to the injured worker about factors like where they should get authorized medical treatment, but it also helps to make sure that things like post-accident drug screenings are completed and more.

When you're talking about a temp staffing agency in the southeast, things are inherently a bit more complicated because there are so many parties involved.

Here, you must effectively communicate all reporting procedures to each client company to help make sure that accidents are being reported A) correctly, and B) in a timely manner.

This helps to minimize delays in the injured worker getting the authorized medical treatment they need.

Throughout it all, a temp staffing agency will also need to make sure that a client is willing to cooperate with the necessary accident investigations that are taking place.

Things like machinery inspections, loss control inspections, and more are often needed for compensability determination, subrogation determination, and other pivotal functions.

All this is to say that while workers' compensation claims management is an inherently time-consuming process, particularly within the context of a temp staffing agency, it is still one that it is possible to master for the benefit of all involved.

Getting to that point simply requires you to keep a few key things in mind. 


The Challenge Of Managing Workers' Compensation Claims

By far, the biggest challenge of managing workers' compensation claims comes by way of the inherent complexity of claims management as a concept.

Here, a temp staffing agency will need to make sure that all supervisory staff is properly trained, that clear expectations are being provided to client companies regarding post-accident reporting procedures, and that client companies are willing to assist with accident investigations.

When supervisory staff is properly trained, they can help assist the injured worker in finding an authorized treatment provider to make sure not just that they're getting essential care, but that they're doing so in a way that will ultimately be paid for.

Communicating reporting expectations can ensure that clients don't cause unnecessary delays in accident notifications and more, which can delay an injured worker from getting the authorized medical treatment they need to return to the job.

If a client is unwilling to assist in investigations (or is unaware that they are supposed to do so), it could further complicate things because elements like witness and supervisor statements will be unavailable. 

These are all fundamental elements that are essential enough to warrant repeating.

They are the rock-solid foundation upon which every other part of the workers' compensation claims management process will be built and without them, your organization is potentially in trouble before it has even had a chance to properly begin.


Common Claims Management Obstacles

One of the most common challenges that temp staffing agencies often face when it comes to claims management has to do with the establishment of a light-duty program.

As the employer of record, it is crucial to have such a program established because not every client will be able to accommodate light-duty restrictions as required.

If a light-duty program isn't available, this could easily lead to a situation where lost time wages are suddenly due.

As is true in any process where so many different parties are involved, another common challenge has to do with a lack of cooperation with a client company regarding accident investigations.

In no uncertain terms, the burden is on the temp staffing agency to make sure that any client they take on is willing to assist a claims adjuster with accident investigations.

This is often necessary to determine claim compensability, subrogation potential, and more.

Finally, untimely notifications following an on-the-job accident are another regular hurdle.

The process can't begin in earnest if the right people don't know an injury has taken place to begin with.

Accident reporting protocols must be reported to all client companies.

If a client isn't providing immediate notifications of on-the-job accidents, it can cause a ripple effect throughout the rest of the process in the worst possible way.

At a bare minimum, it will delay the injured worker from getting the authorized medical treatment they need, which can take an already bad situation and make it even worse.

It could also easily create a situation where the injured worker doesn't just seek medical treatment on their own - they also start seeking legal representation on top of it.

Navigating The Workers' Compensation Claims Process

To help make the workers' compensation claims process go as smoothly as possible, begin by verifying that all employees are aware of your post-accident reporting procedures.

Everyone - including the injured worker - should know what they need to do and when they need to do it.

This includes post-accident drug screens.

It's also important to understand the exact workers' compensation claims process before you need to rely on it.

This includes:

  1. Making sure that the injured employee is being directed to the company physician, as well as that they have access to resources like the employers' Posted Panel, in the aftermath of an on-the-job accident.
  2. Beginning the accident investigation process immediately after the injury in question is reported.
  3. Timely reporting of all claims to your carrier/TPA.
  4. Having a time-specific action plan in place to guarantee that all required steps have been completed in an accurate and timely fashion.


The Role Of Temp Staffing Agencies

Again, things get a bit more complex when you're talking about a temp staffing agency in particular due to the unique relationship between the agency, its own clients, and the workers.

Temp staffing agencies need to make sure that all client companies are being kept up-to-date with any changes in their accident reporting procedures.

This includes adjustments regarding who to contact to report an on-the-job accident.

A temp staffing agency will also want to make sure that employees are in the loop on those same changes, including where to get post-accident drug testing.

Overall, it's also the responsibility of a temp staffing agency to make sure that they're following all requirements in the states in which they are conducting business.

This can include things like having the Employers' Posted Panel posted, utilizing resources like the Choice of Physicians Form, and more.


Reaping The Benefits Of Effective Claims Management

The most immediate benefit that temp staffing agencies will receive as a result of mastering the workers' compensation claims management process comes by way of an unbeatable level of cost-savings.

Injured workers will utilize a company-approved physician rather than the emergency room for non-emergent injuries, for example.

This is huge, because when employees go to an approved physician rather than the emergency room, you're not dealing with a situation where a hospital is charging significantly more than a physician or even an Urgent Care facility.

People are still getting access to the treatment they need at the quality level they expect, it's just costing everyone a fraction of what it otherwise would to get those results. 

The timely reporting of claims to a carrier/TPA also helps make sure that referrals can be directed to in-network or approved vendors.

Your carrier/TPA will often have a list of approved vendors and providers that they already have pre-existing relationships with - relationships that they're leveraging to your advantage.

Those entities will accept reimbursement rates that are often far below the state fee schedule.

This could result in a significant cost-savings almost immediately.

Note that timely reporting in particular also goes a long way towards avoiding late payment penalties as well.

If you fail to timely begin lost time wages or to reimburse medical providers, for example, you're not only responsible for the original money that you owed, you’ll likely have to contend with extensive fees on top of it. 

Overall, you're accomplishing two very important goals at the exact same time.

First, you're saving a tremendous amount of money without anything in the way of real effort being required.

Those funds can then be funneled into other areas of the organization where they can do the most good.

But most importantly, you're guaranteeing that all injured employees have a quality, timely experience in what is understandably a stressful and upsetting period of their lives - which in and of itself is crucial.


The Impact Of Workers' Compensation Claims Management On Temp Staffing Agency Reputation

How your temp staffing agency handles the workers' compensation claims management process can also have a direct impact, both positively and negatively, on its overall reputation.

Never forget that successful claims management requires clear post-accident communication between all parties including the agency, the injured employee, the client company, and the carrier/TPA.

Because of that, proper execution of post-accident procedures doesn't just enhance your reputation as an agency once - it does it three times at a minimum.

By implementing and effectively executing all post-accident procedures, your employee is more likely to be satisfied with how the outcome of the accident was handled.

This makes them more likely to continue to use your temp staffing agency in the future.

The same is true of the client organizations you've chosen to partner with, and your carrier/TPA as well.


A Stronger Organization Begins With A Stronger Claims Management Process

In the end, having properly trained supervisory staff will go a long way toward ensuring that all post-accident protocols are followed.

Workers' compensation claims management is no laughing matter - it's a critical element that has contributed to the success of your temp staffing agency up to this point.

You need to make sure the injured worker is directed to an authorized treatment provider.

You need to make sure that post-accident drug testing is being completed if required.

Every last expectation needs to be communicated to avoid delays in accident notifications, which can unnecessarily delay the injured worker from receiving the authorized medical treatment they're depending on.

Workers' compensation claims management is like a brick wall in that every element is essential and they're all contributing to something greater than the sum of their parts.

If you pull one brick out of the wall, the entire thing crumbles.

Processes like those outlined above are how you prevent that from happening.

Any delays in beginning the post-accident investigation must be minimized whenever possible.

Claims need to be timely reported to a carrier/TPA to avoid late payment penalties as a result of failure to timely begin lost time wages or to reimburse medical providers.

Does everything outlined above amount to a great deal of effort?

Yes - but it's more than worth it because the process itself is crucial.

This will help your temp staffing agency capture additional cost-savings as a carrier/TPA will likely have in-network providers that accept reimbursement rates below the state fee schedule.

It also helps make sure employees get healthy and get back on the job faster, which is a benefit that is hard to argue with.

If you'd like to find out more information about mastering the workers' compensation claims management process for temp staffing agencies, or if you'd just like to talk about your organization's own needs in a bit more detail, please don't delay - contact us today.
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The AIA Team

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